Accouchement différé d´une grossesse multiple: à propos d´un cas et revue de la littérature

Hassani, Mehdi El; Drissi, Jihad; Benali, Saad; Habib, Abdellah Baba; Kouach, Jaouad; Moussaoui, Driss

doi:10.11604/pamj.2020.36.373.19797

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Prophylactic robotic-assisted transabdominal cerclage by an experienced surgeon is a feasible alternative for patients with cervical insufficiency in higher-order multifetal gestation pregnancies. Hassani et al [30] 2020;1 70(DTT) PPROM at 16 GA and miscarriage of one fetus at 22 GA.…”

Section: Cs (35 + 2 Ga)mentioning

confidence: 99%

Vaginal delivery of triplets after emergency transvaginal cerclage: A case report and literature review

Zou,

Wu,

Yao

2024

Medicine

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Rationale: To report a peculiar case of vaginal delivery of a triplet after emergency transvaginal cerclage and to find a way to optimize some extreme situations encountered in clinical practice after evaluating feasibility. Patient concerns: A 33-year-old gravida 6, para 0050 woman at 21 + 6 weeks of gestation was referred to the obstetric department for opening of the cervical canal. An emergency McDonald cerclage was performed at 22 weeks of gestation after a comprehensive assessment, and the pregnancy ended with vaginal delivery at 24 + 6 weeks of gestation. The postpartum period was normal, and the newborns were discharged to home care after treatment in the neonatal intensive care unit. Interventions: After discussing the risks, the patient requested emergency transvaginal McDonald cerclage at 22 weeks of gestation. Outcomes: Emergency McDonald cerclage was performed at 22 weeks of gestation, and the pregnancy ended with vaginal delivery at 24 + 6/25 weeks of gestation, successfully prolonging gestation by 20/21 days. The postpartum period had no exceptional circumstances, and newborns were discharged to home care after treatment in the neonatal intensive care unit for 104/98/104 days. Lessons: Emergency cerclage seems to be impossible in multiple pregnancies. However, in this case, after a comprehensive assessment, it was feasible to extend the gestational age by emergency cerclage, and prompt and accurate evaluation is important to avoid complications and individualize the following management. In this case, we may find a way to optimize some extreme situations encountered in clinical practice and offer a glimmer of hope for families challenged with multiple pregnancies at risk of preterm delivery. However, more high-quality studies are needed to prove the effectiveness and safety of emergency cerclages in triplets.

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Section: Cs (35 + 2 Ga)mentioning

confidence: 99%

Vaginal delivery of triplets after emergency transvaginal cerclage: A case report and literature review

Zou,

Wu,

Yao

2024

Medicine

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Immunohistochemical features of expression of progesterone receptors of placental structures in premature birth

Tkalich

Poladych

2022

RHW

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The objective: to study the immunohistochemical features of placenta in women with premature birth in 28–33 weeks of pregnancy. Materials and methods. 120 pregnant women (the main group) who were hospitalized and delivered in the Kyiv Perinatal Center during 2018–2020 at a gestation period of 23–33 weeks were examined. The women of the main group were divided into two subgroups depending on the term of birth – the 1st group included patients who delivered at 23–28 weeks of pregnancy, the patients of the 2nd group had labors at 29–33 weeks. Placentas of women in the main group were examined using morphological (histological method – staining with hematoxylin and eosin and van Gieson) and immunohistochemical methods (indirect streptavidin-peroxidase method for determining the expression level of progesterone receptors – PR). Results. Premature maturation of chorionic villi was found in 40 % of placentas of women in the 1st group 1, in 20 % – blood circulation disorders and the presence of acute inflammatory infiltration in the fetal membranes, decidual and chorionic membranes, 10 % – pathological immaturity of the placenta according to the variant of chaotic sclerosed villi. During the immunohistochemical study of RP, an unexpressed reaction was found in the epithelium and stromal cells of stem, intermediate and terminal villi – 1 point; in fetal membranes and extravillous cytotrophoblast – 2 points; in the endothelium of vessels – 0–1 point. In the placentas of women in the 2nd group premature maturation of villi was found in 70 % of cases, pseudoinfarcts of villi which are embedded in fibrinoid occupying a significant area – 45 %, afunctional zones – 55 %, blood circulation disorders – 35 %, pathological immaturity placenta according to the variant of chaotic, sclerosed villi – 20 %, acute inflammatory infiltration in the fetal membranes – 15 %. Immunohistochemical analysis of the placental barrier revealed the highest expression of RP in the nuclei of decidual cell which belong to the maternal structure. It should be noted the presence of expression of progesterone receptors in stem villi, fibroblasts and nuclei of the vessel wall. Minimal or absent expression was determined in the nuclei of other villous structures and their vessels. Conclusions. It was established that the receptivity of progesterone has its own characteristics in placental structures depending on the gestation period, which is an important factor in the choice of management for the prevention and reduction of perinatal losses for this contingent of pregnant women.

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Accouchement différé d´une grossesse multiple: à propos d´un cas et revue de la littérature

Cited by 2 publications

References 6 publications

Vaginal delivery of triplets after emergency transvaginal cerclage: A case report and literature review

Vaginal delivery of triplets after emergency transvaginal cerclage: A case report and literature review

Immunohistochemical features of expression of progesterone receptors of placental structures in premature birth

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